Association between low handgrip strength and obesity with mortality in peritoneal dialysis patients

The association between sarcopenia and obesity in peritoneal dialysis (PD) patients is more complex than that of the general population. The aim of this study was, therefore, to evaluate the association of patient survival with sarcopenia or sarcopenic components and obesity in groups of patients with PD. We retrospectively analyzed a dataset from 199 prevalent PD patients. Measurements including handgrip strength (HGS), appendicular lean mass index, and baseline characteristics, were obtained during the period of study. Patients were divided into four groups according to their HGS and obesity: NH-NO (normal HGS and non-obesity, n = 60), NH-O (normal HGS and obesity, n = 31), LH-NO (low HGS and non-obesity, n = 71), and LH-O (low HGS and obesity, n = 37). The median follow-up interval was 17 months. The Kaplan-Meier curve analysis showed that the LH-O group had the poorest patient survival outcome among the four groups (P < 0.001). The NH-NO group had a better patient survival outcome compared with the LH-NO group. Univariate and multivariate Cox regression analyses showed that the LH-O group had the highest mortality rate compared with the other groups. The NH-NO group had lower mortality compared with the LH-NO group. The present study demonstrated that obesity with low HGS was associated with the greatest mortality rate in groups defined by HGS and obesity.